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4088 Meadowlark RdDate: City of Eagoi 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Permit #: Permit Fee: Date Received: Staff: 2009 RESIDENTIAL PLUMBING PERMIT APPLICATION — C3 r Site Address: U 3 / _z 4 J c J L , k- Pc' Tenant: Suite #: RESIDENT / OWNER Name: 'I'd S -r' ill 43 %' 2 - Phone: 6 5/ - 32 Y - 5'6 4/‘ Address / City / Zip: CONTRACTOR Name: /1 I j L> Ski i IcAK-4A-- 9 11 eCnse #: 6 4,3 fsz f ' / l Address: 0le, , 5114 1. �ar, �Li r, City: (J 071K S State: %t^' 1))J Zip: 5503 3 Phone: J f ' �-� 3 '23 Contact Person: rl TYPE OF WORK New )l Replacement Repair Rebuild Modify Space Work in R.O.W. t" Description of work: PERMIT TYPE RESIDENTIAL )6 Water Heater Water Softener Lawn Irrigation Add Plumbing Fixtures ( RPZ / PVB) ( Main Lower Level) _ Septic System Water Turnaround New Abandonment X g r 5-1-061.- s lees RESIDENTIAL FEES: $50.50 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $.50 State Surcharge) $30.50 Lawn Irrigation $50.50 Add Plumbing *Water Turnaround $100.50 Septic System $90.50 Fire Repair (replace (includes $.50 State Surcharge) Fixtures, Septic System Abandonment, Water Turnaround* (includes $.50 State Surcharge) (add $165.00 if a 5/8" meter is required) New ($10.00 per as built) (includes County fee and $.50 State Surcharge) burned out appliances, ductwork, etc.) (includes $.50 State Surcharge) TOTAL FEES $ I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x (.%9,/ L r r,J t)0%, Applicant's Printed Name te° 7 FOR OFFICE USE', Required Inspections: Under G Rough -In Gas Test Final City of Ea�ali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694- ��1 zio ! ri 4/& - 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: 4/ 1-7 I 10 Site Address: 61 2- 1-M, r&-& \vtL l� a U /e, 4 ! ?Z. I r Use BLUE or BLACK Ink Permit #: 46/: Permit Fee: _ 35722/ 5 __ Date Received: Staff: Tenant: Suite #: RESIDENT / OWNER Name: ld> 1-10a 'r L 5k' . 0 6:A4 � 'hone" 9 4-4- 4) -2. - D6O Address/City/Zip: .<5--)D1 kNeee-11\h(`JO • `&, L L '"Vi, -L Applicant is: Owner Contractor TYPE OF WORK Description of work: '-1-e41/70-fl (�,.J. lie✓4.;4 LI 4 '.541,1%1 14 �h y) t Construction Cost: a) - 1 r; , Multi -Family Building: (Yes / No ) CONTRACTOR Name: `S /J Si-) LJ License #: .1.). 51_ cg 12 Address: 11 b61 ita 2-e{ Alt I- ).-11t4,.( City: like a l 1 -e. -d State: Mn.) Zip: y Phone: QJ 3 -.)-1L -Till"/ Contact: 1_-4 r✓1 Email: 041,G,- e. L< GJe l -ALL- : c w'1 COMPLETE In the last 12 months, has Yes No If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information.. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Cali at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gooherstateonecall.orq 1 hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance th the aplgroved plan in the case of work which requires a review and approval of 4,1 Applicant's Printed Name x Afiplinature Page 1 of 3 City of Eagsan 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r -+ For Office Use Permit #: Permit Fee: Date ReceivedAuy 009 Staff 2009 RESIDENTIAL BUILDING PERMIT APPLICATION C ?.Uxd /2 Date: $' 1 Z - 6 Site Address: I-1° tAl 14 d c ' L k" /( 4 Tenant: Suite #: RESIDENT / OWNER Name: ./C).. O if- A 2, 4%1) Phone: ( 32 V - 5(.C/5 Address / City / Zip: C% �f L `�✓� �'� Applicant is: Owner Contractor TYPE OF WORK Description of work: I -C3 r 1-,, / r-- ; .ti , s Lt Construction Cost: / c'j 6c C Multi -Family Building: (Yes )0 / No ) CONTRACTOR Name: )0P- x. -e 1-- . del It -11 % tXl` »") License #: )Q ! 34- 3 3' Address: 3 26 6 1,---- :s ,4 -0-z-,-9 (..v✓i City: 4 AS T i J State: ` ."--"/ Zip: 3- cJ 3 11 Phone: cif/3 Contact Person: 6 ' ,4 € 60-9k?-- COMPLETE Energy Code Category ('J submission type) In the last 12 months, has Yes If yes, THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 Minnesota Rules 7672 _ • Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet Submitted Submitted • Energy Envelope Calculations Submitted the City of Eagan issued a permit for a similar plan based on a master plan? date and address of master plan: _No Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that they are trade secrets. I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x li 0,4 roc' L Applicant's Printed Name x Applicant's $ignatde Page 1 of 3 CITY Or EAGAN Permit No: Date. 3830 Pilot Knob Road Meter No: Size. P.O. Box 21199 Reader No: Date* Eagan, MN 55121 Owner: Site Address. Plumber: Conn. Chg: Zoning. Acct. Dep: No. of Units* Permit Fee. Surcharge. I agree to comply with the City of Eagan Tr. Plant Ordinances. Meter. r/ Misc • B tlC� WATER SERVICE PERMIT CITY OF EAGAN Permit No: Date. 3830 Pilot Knob Road B/P No: Date. Rt. Box 21199 Eagan, MN 55121 Owner: Site Address: Plumber MWCC• Zoning. City Chg: No. of Units. Acct. Dep: I agree to comply with the City of Eagan Permit Fee: Ordinances. Surcharge. Misc • By SEWER SERVICE PERMIT 60. C!tyofEaaii Date: 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 s r Use BLUE or BLACK Ink For Office Use Permit #: 1 3a3 Permit Fee: /' S Date Received: 60 13/ 13 Staff: 2013 RESIDENTIAL BUILDING PERMIT ( APPLICATION -` 1- LS Site Address: l(,I' - ilQgq - O8 - 1 o88 5. / (ei ctoJQf^f/ Name: La61,00001 -kWh 614€ f 1& - Phone: Address / City / Zip: Applicant is: Owner Contractor Description of work: -j-eo (CC Construction Cost: o� 00 Multi -Family Building: (Yes X' l Ms ) Company: /1)M J riQ%S 1'ty SAA lAk- Contact: 5111A ,dire] / Address: 10701 `731M1 AtT. N City: /lope. GrO V . State: A) Zip: 523 05 Phone: C7 ,3Q51f3 1�-snf ` g<1 /0 0 #: License /� Lead Certificate #: fV �ffi' (;21110 - If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor Phone: Sewer & Water Contractor: Phone: IN©TE: Plans and supporting documents that you subs r ars corrsldened fo be pubi c In forma on. Portions o, the infor ra# a naJ be a%moi as non -publi CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.goaherstateonecall.orq I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota StalBui� �r)j o �, must be completed within 180 days of permit issuance. x c12 of_ Applicant's Printed Name x Applicant's Sijriature Page 1 of 3 City of Eagan PERMIT IP1' City of Eaan Permit Type: Building Permit Number: EA138506 Date Issued: 08/31/2016 Permit Category: ePermit Site Address: 4088 Meadowlark Rd Lot: 4 Block: 10 Addition: Hillandale 3rd PID: 10-32952-10-040 Use: Description: Sub Type: Windows/Doors Work Type: Replace Description: Two or More Windows/Doors Census Code: 434 - Zoning: Square Feet: 0 Construction Type: Occupancy: Comments: Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Fee Summary: Valuation: 4,000.00 BL - Base Fee $4K $103.25 Surcharge - Based on Valuation $4K $2.00 0801.4085 9001.2195 Total: $105.25 Contractor: Home Depot At Home Services 6224 Lakeland Avenue N, #102 Booklyn Park MN 55428 (763) 542-8826 - Applicant - Owner: Jose D Morazan 4088 Meadowlark Rd Eagan MN 55122 (651) 324-5645 I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Applicant/Permitee: Signature Issued By: Signature I— For Office Use c t r # / e c # :::::e:' ( „0 E AG A e.�. oer / -!/ (D - a Date Received: `( 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 ' �'”' W.:"'"-,.. I (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675- .4Staff: I buildinginspections(a cityofeagY an.com "" r 2019 RESIDENTIAL BUILD E MIT APPLICATION Date: Site Address: I? _ '//V eS3 5-, ilka JJr✓l!!/< gd. Unit#: Name: . Phone: Resident/ Owner Address I City I Zip: Applicant is: Owner Contractor Type of Work Description of work: Yt L 14 ,,n,',-f c.fie.11 1 Construction Cost: s'7 '7 00 w_ Multi-Family Building: (Yes I No ) Company: ()4-rc, t. J n S 4-f-4,,,c /-7-,)-) Contact: 1. 1;,--0-- P4,,/YIN) 1 ,,/J Contractor Address: 1./L - ���✓! X If City: �'-'9 s State:lP . Zip: 5-11Z Z Phone: ((5�-Z IO -/O0cEmaiL (t ir', f /I'J % DO NOT WRITE BELOW THIS LINE / g c MeRAco)O-a_ SUB TYPES _ Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) _ Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi >0 Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous X 01 of Plex _ Lower Level — Pool Accessory Building WORK TYPES New Interior Improvement _ Siding Demolish Building* _ Addition _ Move Building _ Reroof _ Demolish Interior _ Alteration _ Fire Repair _ Windows _ Demolish Foundation Replace _ Repair _ Egress Window Water Damage Retaining Wall *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation 4r 3'3/0:— Occupancy .1(2C-3 MCES System Plan Review Code Edition yr)el 2e./r. SAC Units (25% (b 100%_) Zoning P Z7 City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Suppression Required Type of Construction ✓3 Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: 'c Footings (Deck) Final I C.O. Required Footings (Addition) ,4 Final I No C.O. Required Foundation Foundation Before Backfill HVAC_Service Test Gas Line Air Test_Hood Roof:_Ice &Water Final Pool:_Footings Air/Gas Tests _Final Framing 30 Minutes 1 Hour Drain Tile Fireplace:_Rough In _Air Test _Final Siding:_Stucco Lath Stone Lath _Brick_EFIS Insulation Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Fire Suppression:_Rough In Final Braced Walls Erosion Control Shower Pan Other: Reviewed By: 141 in • J- (it�' , Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit& Surcharge Treatment Plant Radio Meter Read Copies TOTAL Page 2 of 3